Justin M Canada1, Tae Shik Park, Krishna Ravindra, Juan G Chiabrando, Marco Giuseppe Del Buono, Jessie van Wezenbeek, Cory R Trankle, Dinesh Kadariya, Larry Keen, Salvatore Carbone, Hayley Billingsley, George F Wohlford, Ross Arena, Benjamin W Van Tassell, Antonio Abbate. 1. VCU Pauley Heart Center (Drs Canada, Park, Chiabrando, Del Buono, Trankle, Kadariya, Carbone, and Abbate, Mr Ravindra, and Mss van Wezenbeek and Billingsley), Department of Kinesiology & Health Sciences, College of Humanities & Sciences (Dr Carbone and Ms Billingsley), and Department of Pharmacotherapy and Outcome Sciences (Drs Wohlford and Van Tassell), Virginia Commonwealth University, Richmond; Interventional Cardiology Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Dr Chiabrando); Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy (Dr Del Buono); Department of Psychology, Virginia State University, Petersburg (Dr Keen); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (Dr Arena).
Abstract
PURPOSE: Cardiopulmonary exercise testing (CPX) is a well-established assessment with important insight into prognosis and therapeutic efficacy in patients with heart failure (HF). Prior studies have identified several clinical differences between Black or African American (B-AA) and Caucasian patients with HF. Differences in key CPX responses between these two groups require further investigation. METHODS: Using a database consisting of subjects with symptomatic HF who had undergone CPX for inclusion in various prospective randomized clinical trials, we identified 198 (n = 94 [47%] B-AA; n = 105 [53%] Caucasian) patients with a qualifying baseline CPX. Significant univariate predictors of peak oxygen uptake (V˙o2peak) were included in a multivariate linear regression model. RESULTS: When compared with Caucasian patients, B-AA were younger (mean ± SD = 54.8 ± 10.0 vs 57.9 ± 9.6 yr, P = .03), had higher C-reactive protein (CRP) (median [IQR] = 4.9 [2.3, 8.8] vs 1.9 [0.6, 5.5] mg/L, P < .0001), lower hemoglobin (13.0 ± 1.8 vs 13.8 ± 1.6 g/dL, P = .003), and lower left ventricular ejection fraction (LVEF) (40 [32, 51] vs 53 [43, 59]%, P < .00010). During CPX, B-AA patients also had lower V˙o2peak (14.6 ± 3.9 vs 17.6 ± 4.8 mL·kg-1·min-1, P < .0001). No differences were observed between B-AA and Caucasian in the minute ventilation/carbon dioxide production (V˙e/V˙co2) slope (P = .14). The difference in V˙o2peak between B-AA and Caucasian was largely attenuated after adjusting for age, body mass index, CRP, N-terminal pro-brain natriuretic peptide, hemoglobin, LVEF, and peak HR (14.1: 95% CI, 13.2-14.9 vs 15.6: 95% CI, 14.4-16.8 mL·kg-1·min-1, P = .053). CONCLUSIONS: Directly measured V˙o2peak was significantly lower in B-AA than in Caucasians with HF. This is largely explained by differences in clinical characteristics, whereas no significant differences were observed in the V˙e/V˙co2 slope.
PURPOSE: Cardiopulmonary exercise testing (CPX) is a well-established assessment with important insight into prognosis and therapeutic efficacy in patients with heart failure (HF). Prior studies have identified several clinical differences between Black or African American (B-AA) and Caucasian patients with HF. Differences in key CPX responses between these two groups require further investigation. METHODS: Using a database consisting of subjects with symptomatic HF who had undergone CPX for inclusion in various prospective randomized clinical trials, we identified 198 (n = 94 [47%] B-AA; n = 105 [53%] Caucasian) patients with a qualifying baseline CPX. Significant univariate predictors of peak oxygen uptake (V˙o2peak) were included in a multivariate linear regression model. RESULTS: When compared with Caucasian patients, B-AA were younger (mean ± SD = 54.8 ± 10.0 vs 57.9 ± 9.6 yr, P = .03), had higher C-reactive protein (CRP) (median [IQR] = 4.9 [2.3, 8.8] vs 1.9 [0.6, 5.5] mg/L, P < .0001), lower hemoglobin (13.0 ± 1.8 vs 13.8 ± 1.6 g/dL, P = .003), and lower left ventricular ejection fraction (LVEF) (40 [32, 51] vs 53 [43, 59]%, P < .00010). During CPX, B-AA patients also had lower V˙o2peak (14.6 ± 3.9 vs 17.6 ± 4.8 mL·kg-1·min-1, P < .0001). No differences were observed between B-AA and Caucasian in the minute ventilation/carbon dioxide production (V˙e/V˙co2) slope (P = .14). The difference in V˙o2peak between B-AA and Caucasian was largely attenuated after adjusting for age, body mass index, CRP, N-terminal pro-brain natriuretic peptide, hemoglobin, LVEF, and peak HR (14.1: 95% CI, 13.2-14.9 vs 15.6: 95% CI, 14.4-16.8 mL·kg-1·min-1, P = .053). CONCLUSIONS: Directly measured V˙o2peak was significantly lower in B-AA than in Caucasians with HF. This is largely explained by differences in clinical characteristics, whereas no significant differences were observed in the V˙e/V˙co2 slope.
Authors: Marco Guazzi; Volker Adams; Viviane Conraads; Martin Halle; Alessandro Mezzani; Luc Vanhees; Ross Arena; Gerald F Fletcher; Daniel E Forman; Dalane W Kitzman; Carl J Lavie; Jonathan Myers Journal: Eur Heart J Date: 2012-09-05 Impact factor: 29.983
Authors: Walter J Paulus; Carsten Tschöpe; John E Sanderson; Cesare Rusconi; Frank A Flachskampf; Frank E Rademakers; Paolo Marino; Otto A Smiseth; Gilles De Keulenaer; Adelino F Leite-Moreira; Attila Borbély; István Edes; Martin Louis Handoko; Stephane Heymans; Natalia Pezzali; Burkert Pieske; Kenneth Dickstein; Alan G Fraser; Dirk L Brutsaert Journal: Eur Heart J Date: 2007-04-11 Impact factor: 29.983
Authors: Massimo F Piepoli; Viviane Conraads; Ugo Corrà; Kenneth Dickstein; Darrel P Francis; Tiny Jaarsma; John McMurray; Burkert Pieske; Ewa Piotrowicz; Jean-Paul Schmid; Stefan D Anker; Alain Cohen Solal; Gerasimos S Filippatos; Arno W Hoes; Stefan Gielen; Pantaleo Giannuzzi; Piotr P Ponikowski Journal: Eur J Heart Fail Date: 2011-04 Impact factor: 15.534
Authors: Jessie van Wezenbeek; Justin M Canada; Krishna Ravindra; Salvatore Carbone; Cory R Trankle; Dinesh Kadariya; Leo F Buckley; Marco Del Buono; Hayley Billingsley; Michele Viscusi; George F Wohlford; Ross Arena; Benjamin Van Tassell; Antonio Abbate Journal: Front Cardiovasc Med Date: 2018-12-21